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Anales de Otorrinolaringología Mexicana

Anales de Otorrinolaringología Mexicana
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2012, Number 2

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Otorrinolaringología 2012; 57 (2)

Eficacia del subgalato de bismuto, como agente hemostático tópico, en el sangrado transoperatorio de la adenoamigdalectomía o amigdalectomía

Moreno PR, Martínez VC, Romero AJ, Márquez M, Cervantes GS, Almeida GY, Flores MA
Full text How to cite this article

Language: Spanish
References: 9
Page: 65-68
PDF size: 179.75 Kb.


Key words:

bismuth subgallate, intraoperative bleeding, adenotonsillectomy, tonsillectomy.

ABSTRACT

Introduction: Adenotonsillectomy (AT) or tonsillectomy (T) is one of the most common procedures, which has few complications, but one of them is bleeding. Bismuth subgallate (SGB) has been used topically on the tonsillar fossa in order to reduce intraoperative bleeding.
Objective: To determine the efficacy of topically applied SGB to reduce perioperative bleeding in patients undergoing adenotonsillectomy (AA) or tonsillectomy (A).
Design: A prospective, randomized controlled and multicenter trial. Accepted by the Central Committee of Investigation of the IMSS.
Patients and method: One hundred and eigtheen patients aged 3 to 60 admitted for elective AT or T. These patients were randomized. In the study group SGB was used after removal. In the control group dry gauze was used. Bleeding, surgical time and the number of tonsilar sutures used were quantified.
Results: A total of 118 patients were randomized to the study, between 3 and 60 years old, who underwent T or AT. The distribution was 55 patients for subgallate group and 63 patients in the placebo group. No significant differences were found with the use of SBG in intraoperative bleeding (p = 0.85), but there were significant differences in the use of points in the tonsillar bed (p = 0.010) postoperative bleeding was present in 1.7%, there were no significant differences with the use of subgallate (p = 0.283).
Conclusion: SGB applied on the tonsillar bed showed no activity as a hemostatic agent to decrease intraoperative bleeding after adenotonsillectomy or tonsillectomy.


REFERENCES

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  2. Sorensen WT, Henrichsen J, Bonding P. Does bismuth have haemostatic effects in tonsillectomy? Clin Otolaryngol 1999;24:72-74.

  3. Maniglia AJ, Kushner H, Cozzi L. Adenotonsillectomy a safe outpatient procedure. Arch Otolaryngol Head Neck Surg 1989;115:92-94.

  4. Thorisdottir H, Ratnoff OD, Maniglia AJ. Activation of Hageman factor (factor XII) by bismuth subgallate, a hemostatic agent. J Lab Clin Med 1988;112:481-486.

  5. Callanan V, Curran AJ, Smyth DA, Gormley PK. The influence of bismuth subgallate and adrenaline paste upon operating time and operative blood loss in tonsillectomy. J Laryngol Otol 1995;109:206-208.

  6. Hatton RC. Bismuth subgallate-epinephrine paste in adenotonsillectomies. Ann Pharmacother 2000;34:522-525.

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  9. Montes de Oca D, Girón M, Moreno M. Subsalicilato de bismuto, como agente hemostático, en adenoamigdalectomía de estancia breve. An Orl Mex 1991;36:123-125.




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Otorrinolaringología. 2012;57